OBJECTIVES: To describe the dermatological changes associated with continuous subcutaneous insulin infusion (CSII) therapy in youth with type 1 diabetes mellitus (T1D). To assess their association with duration of CSII, age, adiposity, HbA1(c), insulin dose, insulin brand, infusion set or site. STUDY DESIGN: We conducted a cross-sectional study of 50 consecutive patients with T1D who were using CSII for >6 months (26 female; age, 13.3 +/- 3.5 years [mean +/- SD]; CSII duration, 2.8 +/- 1.7 years; HbA1(c), 7.7% +/- 1.1%). A grading scale was devised. Ultrasound scanning was performed in 8 subjects. RESULTS: The mean (+/-SD) severity score was 6.3 +/- 3.5 (range, 0-14; maximum possible, 69). Most common were scars <3 mm diameter (94%), erythema not associated with nodules (66%), subcutaneous nodules (62%), and lipohypertrophy (42%). There was a significant negative correlation between severity score and body mass index z-score (r = -0.3, P = .039), but no correlation with HbA1(c), insulin brand or site. Infusion sets inserted at 90 degrees were associated with lower scores (P = .03). Less than 5% of patients and parents considered stopping CSII because of skin concerns. Ultrasound scanning results of CSII sites revealed mild increased echogenicity of the dermis and hypodermis. CONCLUSIONS: Dermatological changes were frequent, with increased severity associated with lower adiposity. These complications were not associated with glycemic control, nor did they prompt most to consider stopping CSII.
OBJECTIVES: To describe the dermatological changes associated with continuous subcutaneous insulin infusion (CSII) therapy in youth with type 1 diabetes mellitus (T1D). To assess their association with duration of CSII, age, adiposity, HbA1(c), insulin dose, insulin brand, infusion set or site. STUDY DESIGN: We conducted a cross-sectional study of 50 consecutive patients with T1D who were using CSII for >6 months (26 female; age, 13.3 +/- 3.5 years [mean +/- SD]; CSII duration, 2.8 +/- 1.7 years; HbA1(c), 7.7% +/- 1.1%). A grading scale was devised. Ultrasound scanning was performed in 8 subjects. RESULTS: The mean (+/-SD) severity score was 6.3 +/- 3.5 (range, 0-14; maximum possible, 69). Most common were scars <3 mm diameter (94%), erythema not associated with nodules (66%), subcutaneous nodules (62%), and lipohypertrophy (42%). There was a significant negative correlation between severity score and body mass index z-score (r = -0.3, P = .039), but no correlation with HbA1(c), insulin brand or site. Infusion sets inserted at 90 degrees were associated with lower scores (P = .03). Less than 5% of patients and parents considered stopping CSII because of skin concerns. Ultrasound scanning results of CSII sites revealed mild increased echogenicity of the dermis and hypodermis. CONCLUSIONS: Dermatological changes were frequent, with increased severity associated with lower adiposity. These complications were not associated with glycemic control, nor did they prompt most to consider stopping CSII.
Authors: Parul J Patel; Kari Benasi; Gina Ferrari; Mark G Evans; Satya Shanmugham; Darrell M Wilson; Bruce A Buckingham Journal: Diabetes Technol Ther Date: 2013-10-03 Impact factor: 6.118
Authors: Rachel S Rigo; Laura E Levin; Donald V Belsito; Maria C Garzon; Rachelle Gandica; Kristen M Williams Journal: J Diabetes Sci Technol Date: 2020-05-09
Authors: Andrew W Karlin; Trang T Ly; Laura Pyle; Gregory P Forlenza; Laurel Messer; R Paul Wadwa; Daniel J DeSalvo; Sydney L Payne; Sarah Hanes; Paula Clinton; David M Maahs; Bruce Buckingham Journal: Diabetes Technol Ther Date: 2016-05-26 Impact factor: 6.118